From Balloon Juice to the NY Times

Me last week:

There are a couple of categories of people who are undeniably worse off under Obamacare than they would have been under a no change policy. They can be clustered into a few broad groups.

  • People earning over $250,000 per year in Modified Adjusted Gross Income who have employer sponsored health care or Medicare and are paying more in taxes
  • Young single males with absolutely no health problems, no relatives with health problems and incomes over 250% Federal Poverty Line that previously had a $42 a month, $25,000 deductible plans that did not cover maternity or mental health needs. Those policies got cancelled and they actually have to buy good insurance. Young guys making under $25,000 a year usually will get decent subsidies, past that, it is hard to be sympathetic to someone bitching that they (a member of a high accident group) have to buy decent insurance. Avik Roy has been trying to make this class sympathetic and failing miserably)

Those are the two big classes of losers under the law. Neither are particularly sympathetic.

Paul Krugman on the Op-ed page yesterday in the NY Times:

Why can’t the right find these people and exploit them?

The most likely answer is that the true losers from Obamacare generally aren’t very sympathetic. For the most part, they’re either very affluent people affected by the special taxes that help finance reform, or at least moderately well-off young men in very good health who can no longer buy cheap, minimalist plans. Neither group would play well in tear-jerker ads.

 I’ll take this as a win.

46 replies
  1. 1
    srv says:

    Congrats. Just for the record, I’m not K-thug.

  2. 2
    catclub says:

    I read that Krugman yesterday, and it was utterly familiar.

    Well done.

  3. 3
    catclub says:

    @srv: Spartacus r Vs

  4. 4
    Gin & Tonic says:

    Well done. I wonder what nym the good professor uses here. Let the speculation begin.

  5. 5
    evolved beyond the fist mistermix says:

    I thought of you when I saw that – and he has mentioned that he reads B-J in the past.

  6. 6
    dmsilev says:

    @srv: But if you were Krugman, you’d say you weren’t just to throw us off the trail.

    So, maybe you are.

  7. 7
    Belafon says:

    What’s the video?

  8. 8
    Richard Mayhew says:

    @evolved beyond the fist mistermix: I was betting K-thug saw it via Brad Delong and the Equitablog….

  9. 9

    @Gin & Tonic:

    I wonder what nym the good professor uses here.

    I suspect he’s only a lurker.

  10. 10
    Commenting at Balloon Juice since 1937 says:

    That’s borderline plagiarism. The NYT owes you some cake.

  11. 11
    ShadeTail says:

    @Belafon: Snoopy’s Happy Dance (31 seconds long).

  12. 12
    Elizabelle says:

    Well done, Mr. Mayhew.

  13. 13
    Mnemosyne says:

    I remember hearing some sympathetic stories from our fellow B-Jers with highish incomes on paper but somewhat complicated personal situations (like having an underwater mortgage or non-custodial child support) where it looked like they were going to get shorted on subsidies, but I don’t think we’ve heard from them lately. Hopefully they were able to get things straightened out and didn’t just drop out in frustration.

  14. 14
  15. 15
    Villago Delenda Est says:

    Yup, it’s a win!

    You kick ass, Richard!

  16. 16
    Villago Delenda Est says:

    @Roger Moore:

    Really, why tip his hand?

  17. 17
    Elizabelle says:

    Why, why, why is it that an intelligent health industry analyst, writing on a snarky blog, can connect the dots and figure out what’s happening, but our professional journalists at the New York Times and Washington Post can accomplish no same feat?

    Why, why, why?

  18. 18
    Gex says:

    @Elizabelle: Same as it ever was. You can’t get people to understand something they are being paid not to understand.

  19. 19
    catclub says:

    @Elizabelle: Tanta also died too soon.

  20. 20
    Villago Delenda Est says:


    You beat me to it. But that’s what is going on here.

    Also, too, there are tiger shrimp and cocktail weenies in Georgetown that won’t eat themselves.

  21. 21
    Another Holocene Human says:

    Well done. :)

  22. 22
    Alex says:

    In related news, the latest round of criticism on the AFP ads (where people get better insurance under Obamacare, but the “uncertainty” means that they are going to die) has resulted in conservatives loudly insisting that it’s never ok to criticize cancer patients.

    Weirdly, the substance of the ads have presented a convincing case for a single payer system. Since any form of disruption in health insurance is bad wrong, the only solution is to force everyone to have some form of government-provided health care or insurance.

  23. 23
    Another Holocene Human says:

    @Xantar: I think IT contracting has always been this bad but when it was a state DOT that was getting roached they could just extend the deadlines through multiple administrations.

    Gov’ts should have their own IT depts and they should be accountable. That doesn’t mean nothing gets contracted out but it does mean people with technical knowledge and experience managing IT projects managing the contractors and not just clueless n00b patronage hires or, worse, “industry” hires with ties to the fucking contractor!

    The rot has been exposed by the forced deadline. Who knew the feds after some serious fucking up by cabinet level officials could pull something out of a hat better than our laboratories of democracy? (Er… me not surprised, most US states are much smaller and easier to screw over, though Massachusetts did surprise me, tha fuck, Massachusetts?)

  24. 24


    Since any form of disruption in health insurance is bad wrong, the only solution is to force everyone to have some form of government-provided health care or insurance.

    I think the wingnuts would argue that the real solution is to ban health insurance.

  25. 25
    JCJ says:

    @Richard Mayhew:

    OT, but I saw your post last week about the soccer official who wanted nothing to do with “Obamacare.” I had a patient about 16 months ago with rectal cancer that the surgeon (a fellowship trained colorectal surgeon) stated could not be removed without a permanent colostomy unless he underwent pre-operative radiation (with chemotherapy), and even then there would be no guarantee of being able to preserve the anal sphincter. In addition, the cancer was clinical stage T3 for which pre-operative treatment is standard therapy. The patient was difficult to convince on this course, but he eventually agreed to everything. He did not have insurance and initially said he would pay for everything out of pocket until he learned how much all of this costs. He then insisted on waiting three weeks to begin even the initial planning steps for radiation until he was sure he had Medicaid. He got through the pre-operative chemotherapy and radiation, had surgery with a temporary colostomy, had the re-anastomosis surgery done, refused additional chemotherapy (additional chemotherapy is standard,) and has done well. He recently cancelled a follow up appt with his medical oncologist because Scott Walker has limited Medicaid here in Wisconsin and he no longer has this for insurance. When he was informed that he could go look at the exchanges for insurance he stated he wanted nothing to do with Obamacare and did not want any charity. All this after being on Medicaid earlier.

  26. 26
    rikyrah says:

    You were on point.

    Thank you.

  27. 27
    Tractarian says:

    Pretty sure Drum got there first.

  28. 28
    Davis X. Machina says:

    @JCJ: Surgical resection of mean-and-stupid still is in clinical trials.

  29. 29
    srv says:

    @Another Holocene Human: Public sector just can’t pay or retain good staff, fewer benefits, low pay and then they’ll still get outsourced.

    Your program is only as good as its weakest link, and there are an awful lot of weak links out there. How weak? I wish I could talk, but thank god a lot of states didn’t have their own exchanges.

  30. 30

    Drum got to the “AFP ads suck because they can’t find any real victims” before Mr. Mayhew did- he actually links to Drum in the post from a week ago- but Drum didn’t include the part about the groups who are genuinely worse off under Obamacare and why they aren’t very sympathetic. I think that’s an important amplification of the underlying point.

  31. 31
    Astor Column says:

    It’s a great feeling when the world recognizes how cogent your thinking is. It would be an even better feeling if you were given credit for it.

    But you’ll have to settle for us booger-eatin’ mouth-breathers clapping you on the back and applauding. Well done, Mr Mayhew!

  32. 32
    Richard Mayhew says:

    @Roger Moore: Exactly — all health care wonks and interested observers agree that there are people who are worse off under Obamacare than no Obamacare. The question is who?

    AFP et al are trying to argue that people with decent pre-1/1 coverage are getting screwed. They’re not, or at least they should not if they are willing to spend time that socialist abomimation of a standardized marketplace where people can buy private health insurance. this argument is being made because someone with cancer and then told to shut up and die is an amazingly sympathetic person. That person doesn’t exist so far.

    The people who are losing are 23 year old men in perfect health, decent jobs that don’t offer group coverage of people with serious money and group coverage as they’re paying more for no personal gain.

  33. 33
    Rob in CT says:


    People are not rational creatures. We’re rationalizing creatures more than we are rational. This is what often gets economists in trouble.

    It’s pretty frustrating.

  34. 34
    Another Holocene Human says:

    @Richard Mayhew: 23 yr old men in perfect health with indigent parents who totally would have bought insurance on the open market assuming they didn’t have plans on Saturday night, oh, and who were infertile and/or gay.

  35. 35
    KithKanan says:

    @Richard Mayhew: don’t forget the other losers, the people falling into the “Individual coverage through their employer is affordable, family coverage is unaffordable but they’re ineligible for subsidies” loophole.

  36. 36
    MomSense says:


    I had a guy go nuts on me last week about how he doesn’t think he should pay taxes. He has paid enough already and was criticizing the government and Obama. He went on and on. He has medicaid for insurance.

  37. 37
    imonlylurking says:

    @Richard Mayhew: all health care wonks and interested observers agree that there are people who are worse off under Obamacare than no Obamacare. The question is who?

    The other question is: how do you define worse off?
    I am going to pay more out of pocket for various reasons, but as an asthmatic that (slight) excess cost is more than outweighed by the fact that I can no longer be denied an insurance policy. That means no more job lock, increased possibility of starting a business, and maybe even retiring early.

  38. 38

    @Richard Mayhew:
    I think the fundamental problem is that AFP wants to argue for repeal rather than repair. It isn’t enough to have people who can obviously afford care who are paying more. To argue for repeal, they need to find people who have actually lost coverage because of Obamacare; that’s the only scare tactic that’s likely to work on people who already have coverage that isn’t directly impacted by Obamacare except that the new rules require it to expand coverage. That’s why they had such high hopes for “If you like your coverage, you can keep it”. In practice, though, the real stories about people losing their coverage are ones who slipped through the cracks through obscure rules or the Medicaid hole in states that refused Medicaid expansion, and they make a much better case for fixing the system than eliminating it.

  39. 39
    Neutron Flux says:

    Very nice. Agreed, for the win.

  40. 40
    Another North Carolinian says:

    @KithKanan: Thank you! My situation exactly.

  41. 41
    satby says:

    @imonlylurking: Right there with you, fellow asthmatic! And no surprise that K-thug or any other writer would leverage Richard’s cogent analysis. Well done Mr. Mayhew!

  42. 42
    J R in WV says:


    Can’t understand the huge number of people who oppose government handouts with dripping vitriol, and who are on multiple government programs themselves!

    “Keep the President’s hands off my Medicare!!” is one of the most outstanding (in the rain, in a pasture) examples of a teabagger spouting this walking contradiction, but far from the only one.

    Your example is even better, this guy could lose his life (worst case), or become tied to a colostomy bag for the rest of his life. So he gets on Medicaid, a government program, to save his life. Which works for him! Great!

    But, to continue receiving health care he needs to visit a government web site to BUY PRIVATE insurance, and he can’t, won’t, will NOT! visit the ACA/Obamacare web site to get private health insurance that wasn’t available to him just a few months ago.

    Just Crazy!

  43. 43
    Fellatio Alger says:

    @JCJ: So you’re saying he had his sphincter removed, but he is still an asshole?

  44. 44
    Barbara says:

    I think it’s worth remembering that being 23 is a temporary condition; as I recall, it only lasts about a year. Eventually, they’ll turn into middle-aged people with all sorts of miscellaneous aches and pains, and they’ll reap the rewards of having health coverage. At least that’s what happened to me.

  45. 45
    Nutella says:

    @Roger Moore:

    “I think the wingnuts would argue that the real solution is to ban health insurance care.”


  46. 46
    Heliopause says:

    Young single males with absolutely no health problems, no relatives with health problems…Neither are particularly sympathetic.

    Wow, no wonder Dems win all the elections, brilliant outreach like this.

    Since BJ is the go-to for ancedotes, here’s mine. I was the young (later middle-aged) male with no health problems for several decades of my adult life. I won’t bore you with all the details of my life choices but suffice it to say that I saved a decent chunk of my income and now have, literally, tens of thousands of dollars to my name that I wouldn’t otherwise have if Obamacare had existed all that time. It’s even costing me something now at this stage of my life.

    Since some of the commenters here will reflexively assume this means I don’t think the law is an improvement on the status quo ante, or that I’m not happy to pay what I can toward a more equitable civil society, I do and I am. I also know I’ve been lucky to have had a long run of good health.

    Point being, it’s kind of stupid to be so cavalier about the concerns of a demographic you might want to at least try to bring into your tent. That is, if you ever want your persistent electoral problems to improve.

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